Provider Demographics
NPI:1558018002
Name:KOPNISKY, KARLA (RDH)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:KOPNISKY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:CO
Mailing Address - Zip Code:80467-0743
Mailing Address - Country:US
Mailing Address - Phone:330-414-6623
Mailing Address - Fax:
Practice Address - Street 1:211 W. OAK ST
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:CO
Practice Address - Zip Code:80467-8046
Practice Address - Country:US
Practice Address - Phone:330-414-6623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist